Change of daily process measures over the study period among the whole cohort and in subgroups of ICUs with baseline spontaneous trial (SAT) compliance of >50% and ≤50.

(PDF)</p

Minimal underlying data.

(XLSX)</p

Outcomes.

Outcomes.</p

Map of Saudi Arabia with distribution of participating ICUs.

(PDF)</p

Distribution of compliance, non-compliance and contraindications (with reasons) to the interventions.

(PDF)</p

Study flow diagram.

Study flow diagram.</p

CONSORT 2010 checklist of information to include when reporting a randomised trial*.

(DOC)</p

List of interventions.

(PDF)</p

Forest plots for the change in spontaneous awakening trial (SAT) compliance and ICU mortality in different subgroups.

The p-value for interaction is shown. Additional subgroup analyses are provided in supplement for subglottic suctioning, spontaneous breathing trial (SBT) and ventilator associated events (VAEs). Footnotes: ** The random effect Poisson regression was used to estimate incidence rate ratio after incorporating ICU unit and hospital as random effects.^^ The random effect negative binomial regression was used to estimate incidence rate ratio after incorporating ICU unit and hospital as random effects. IRR: Incidence rate ratio, CI: Confidence interval.</p

Forest plots for the change in subglottic suctioning, spontaneous breathing trial (SBT) and ventilator associated events (VAEs) in different subgroups.

** The random effect Poisson regression was used to estimate incidence rate ratio after incorporating ICU unit and hospital as random effects. ^^ The random effect negative binomial regression was used to estimate incidence rate ratio after incorporating ICU unit and hospital as random effects. IRR: Incidence rate ratio, CI: Confidence interval. (PDF)</p